1. Association of Clinical Factors and Recent Anti-Cancer Therapy with COVID-19 Severity among Patients with Cancer: A Report from the COVID-19 and Cancer Consortium
- Author
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Deepak Ravindranathan, T. S. Bekaii-Saab, Minh-Phuong Huynh-Le, Stephanie Berg, David Gill, C. Hennessy, Shuchi Gulati, Zhuoer Xie, Keith Stockerl-Goldstein, Ang Li, Clarke A. Low, D. Y. Reuben, Emily Hsu, Sharad Goyal, Petros Grivas, Chih-Yuan Hsu, D. J. Hausrath, Jessica Hawley, Harry Menon, Huili Zhu, A. Jayaraj, Barry Dixon, Rachel P. Rosovsky, Benjamin French, L. Tachiki, A. J. Piper-Vallillo, Dimitrios Farmakiotis, Daniel Kwon, Susan Halabi, Thorvardur R. Halfdanarson, Gary H. Lyman, Astha Thakkar, Arturo Loaiza-Bonilla, A. Fazio, Sumit A. Shah, Mehmet Asim Bilen, Michael A. Thompson, X. Li, Suki Subbiah, Matthias Weiss, Catherine Curran, E. Tadesse, Christopher McNair, Matthew Puc, Prakash Peddi, Corrie A. Painter, Ali Raza Khaki, Donna R. Rivera, Maryam B. Lustberg, Eric H. Bernicker, Vadim S. Koshkin, A. Nizam, M. Streckfuss, Alice Zhou, Aakash Desai, Sunny R K Singh, John M. Nakayama, Leslie A. Fecher, Samuel M. Rubinstein, Gd L. Lopes, Philip E. Lammers, Yu Shyr, Jaymin M. Patel, J. Crowell, Sanjay Mishra, Anup Kasi, Donald C. Vinh, Leyre Zubiri, Jeremy L. Warner, Nathan A. Pennell, V. Mico, Rana R. McKay, Amit Verma, M. E. Reeves, Daniel W. Bowles, Cathleen Park, Jared D. Acoba, David D. Chism, Gayathri Nagaraj, Matthew D. Galsky, Arielle Elkrief, M. Smits, Kripa Patel, N. L. Nock, Chinmay Jani, Clara Hwang, Mansi R. Shah, Angelo Cabal, Eric B. Durbin, Brian I. Rini, Peter Paul Yu, Tian Zhang, Dimpy P. Shah, M. Salazar, Shilpa Gupta, Lori J. Rosenstein, Christopher R. Friese, Gary K. Schwartz, Andrew Schmidt, Daniel Blake Flora, Justin Shaya, P. Bindal, D. Mundt, Julie Fu, Matthew D Tucker, Trisha Wise-Draper, Toni K. Choueiri, Deborah B. Doroshow, Rohit Bishnoi, E. Wulff-Burchfield, Balazs Halmos, Chintan Shah, Babar Bashir, Solange Peters, Nathaniel Bouganim, Paolo Caimi, Ruben A. Mesa, Maheen Z. Abidi, Daniel G. Stover, Nicole M. Kuderer, Michael Glover, Jia Wu, Punita Grover, Shirish M. Gadgeel, E. S. Nakasone, Douglas B. Johnson, Hina Khan, and Ziad Bakouny
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Male ,0301 basic medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Laboratory measurements ,Disease ,neoplasm ,law.invention ,Cancer ,03 medical and health sciences ,COVID-19 Testing ,0302 clinical medicine ,law ,Neoplasms ,Internal medicine ,medicine ,Humans ,Outcomes ,Pandemics ,Etoposide ,Aged ,Chemotherapy ,SARS-CoV-2 ,business.industry ,COVID-19 ,Hematology ,medicine.disease ,Intensive care unit ,Clinical trial ,030104 developmental biology ,Oncology ,Anti-cancer therapy ,030220 oncology & carcinogenesis ,Cohort ,SARS-CoV2 ,Absolute neutrophil count ,Female ,Original Article ,business ,medicine.drug - Abstract
BACKGROUND: Patients with cancer may be at high risk of adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed a cohort of patients with cancer and coronavirus 2019 (COVID-19) reported to the COVID-19 and Cancer Consortium (CCC19) to identify prognostic clinical factors, including laboratory measurements and anticancer therapies. PATIENTS AND METHODS: Patients with active or historical cancer and a laboratory-confirmed SARS-CoV-2 diagnosis recorded between 17 March and 18 November 2020 were included. The primary outcome was COVID-19 severity measured on an ordinal scale (uncomplicated, hospitalized, admitted to intensive care unit, mechanically ventilated, died within 30 days). Multivariable regression models included demographics, cancer status, anticancer therapy and timing, COVID-19-directed therapies, and laboratory measurements (among hospitalized patients). RESULTS: A total of 4966 patients were included (median age 66 years, 51% female, 50% non-Hispanic white); 2872 (58%) were hospitalized and 695 (14%) died; 61% had cancer that was present, diagnosed, or treated within the year prior to COVID-19 diagnosis. Older age, male sex, obesity, cardiovascular and pulmonary comorbidities, renal disease, diabetes mellitus, non-Hispanic black race, Hispanic ethnicity, worse Eastern Cooperative Oncology Group performance status, recent cytotoxic chemotherapy, and hematologic malignancy were associated with higher COVID-19 severity. Among hospitalized patients, low or high absolute lymphocyte count; high absolute neutrophil count; low platelet count; abnormal creatinine; troponin; lactate dehydrogenase; and C-reactive protein were associated with higher COVID-19 severity. Patients diagnosed early in the COVID-19 pandemic (January-April 2020) had worse outcomes than those diagnosed later. Specific anticancer therapies (e.g. R-CHOP, platinum combined with etoposide, and DNA methyltransferase inhibitors) were associated with high 30-day all-cause mortality. CONCLUSIONS: Clinical factors (e.g. older age, hematological malignancy, recent chemotherapy) and laboratory measurements were associated with poor outcomes among patients with cancer and COVID-19. Although further studies are needed, caution may be required in utilizing particular anticancer therapies. CLINICAL TRIAL IDENTIFIER: NCT04354701.
- Published
- 2021